Dec 19, 2005

A Diagnosis For Online Gaming Syndrome

A Korean doctor has outlined a health risk pattern that predicts death from online gaming. The most common cause of gaming death in Korea, according to Dr. Song Hyeong-gon, is pulmonary thrombo-embolism, a seizure of the cortex. In the gaming cases, it is caused by sudden visual stimulation following long periods of high stress with low physical activity. Eurogamer reports; Chosunilbo Digital had the original story (but I don't have a link).

Makes me wonder: Should Terra Nova have a health category? Should we get a gaming health expert to join us?

Comments

1.

Ted reported (accurately given the source): The most common cause of gaming death in Korea, according to Dr. Song Hyeong-gon, is pulmonary thrombo-embolism, a seizure of the cortex.

And from the linked article: "Because they are stressed by the obsession with winning the game, they consume a considerable amount of energy. In such a physically exhausted condition, exposure to bright colors or stimulating images on the screen is likely to irritate the cerebral cortex and can cause sudden death."

Is it just my bogosometer that's red-lined?

A pulmonary thromboembolism is a blood clot blocking the pulmonary arteries (those leading from the heart to the lungs). The "gaming deaths" in question may or may not have resulted from PTE, I don't know.

But this has nothing to do with the cerebral cortex. It is possible to induce seizures in response to "bright colors or stimulating images on the screen" as reported in the article, but these are well-known as photosensitive seizures that can be brought on by TV or computer games, but also by "flickering or reflected sunlight, lightning, car headlights, flickering artificial lights, arcade games, discotheque or Christmas lights, sharply contrasting patterns, and, rarely, self-induced exposure to flicking light e.g., waving a hand before the eyes."

It's just possible I suppose that someone susceptible to such seizures could have one after hours of play, and that this could cause death in an exhausted person who didn't receive immediate assistance. But that alone seems pretty strange, to say nothing of the supposed connection to PTE.

OTOH, maybe this is somehow related to consumption of foods high in trans-fatty acids, like chips and salsa, during game sessions? Maybe Cheetos should come with a warning for susceptible gamers?

See, this is why I was wondering whether we need to find a medical expert for the site. I don't know about anybody else, but I have no way of knowing whether a predictive or behavioral claim of a person with an MD is accurate or not. We have people here who, I think, are reasonably able to assess mental health claims, especially as pertains to addiction. But what about physical health? There must be a subsector of the HCI community that focuses on human physical health issues that arise when carbon- and silicon-based organisms dance together for a lifetime. I wonder if there isn't a sub-sub-sector that focuses on games in particular.

Well, if anyone is out there - Fred Kron, MD? - it would be interesting to hear your thoughts.

Well, I'm an MD for what little that's worth, and I thought the paragraph about irritating the cerebral cortex was a complete crock.

Photosensitive seizures are a well documented phenomenon, but they are induced by only a small number of video games, generally ones with lots of bright flashing lights and patterns.

Furthermore, the people that get them already have something wrong with their brains -- they may not know they have a seizure disorder until they seize to a videogame, but no amount of "physical exhaustion" will make someone without an underlying disorder have a seizure (yes, you can induce seizures in the otherwise healthy, but it isn't this simple).

But in any event, having a seizure is quite a distinct event from dropping dead playing computer games. To say that "irritat[ing] the cerebral cortex [...] can cause sudden death" is just crazy and ignorant -- it doesn't happen. My one reservation about criticizing this is that this could be a translation problem. Maybe "irritate" was actually "seizure" in Korea -- but seizures still don't make you drop dead (though they can kill, it's a bit more complicated and you can generally survive until reaching a hospital).

The real culprit could easily be deep vein thrombosis. This is the same thing as "economy class syndrome" where people can drop dead after long plane flights. These folks probably also have an underlying predisposition to clotting, but that isn't a terribly rare thing to have and it's something most folks will never know they have -- unless they develop a clot from sitting too long without moving while also dehydrated. You're still safer while playing videogames if yo get up to go to the bathroom periodically and fidget in your seat while playing and drink enough water -- all things that are easier to do while gaming than while on a long plane flight.

Here's a link to the original Chosunilbo article used as a source by Eurogamer. It gives some more details, talks about DVT/economy class syndrome, but seems to link the gaming deaths to stress, exhaustion and poor PC Bang conditions in addition to immobility:

Eoh Gi-jun, the head of the Korea Computer Life Institute, points out that deep vein thrombosis (DVT), the so-called economy class syndrome, can also cause computer-game related death. According to research by the National Institute of Scientific Investigation, the main cause of death during computer games is pulmonary thrombo-embolism. “The games we played in the 1980s were winnable once you found out the programmed rules of the game, but when playing network games you have to compete with millions of players all around the world,” Eoh says. “You may be one of the top ranking players one moment but drop way down the next second. Because of the massive competition, people can’t stop playing.”

Mike Sellers wrote:
OTOH, maybe this is somehow related to consumption of foods high in trans-fatty acids, like chips and salsa, during game sessions? Maybe Cheetos should come with a warning for susceptible gamers?

Or perhaps the rampant smoking that tends to take place in the PC baangs.

As an MD (and a pathologist to boot) I agree with Brent Krupp, and I think the Chosunilbo reporter did a poor job of presenting the data about "computer-game related death." Death in a PC baang due to massive pulmonary thromboembolism is documented here http://www.eymj.org/abstracts/viewArticle.asp?year=2004&page=349
"A new case of fatal pulmonary thromboembolism associated with prolonged sitting at computer in Korea." without any suggestion that epilepsy or gaming per se was a factor.

Thanks to the MDs for this insight. This is certain not to be the last report of direct negative health effects from online gaming. Society's deep-seated discomfort about this activity will probably be expressed fairly frequently as a health risk.

I think you hit the nail on the head right there, Ted. I believe it is indeed a society's discomfort with an activity like gaming that causes concern to be expressed in biomedical terms. I would guess that like addiction, it is a matter of the vocabulary (and credibility) at our disposal when we express things in (pseudo?)-scientific rather than more sociological terms. Rational and neat, versus emotional and messy?

Whether the Eurogamer article is credible or not, I think there is a strong case here for a medical professional to contribute on the site. If the real self is considered one of many avatars, and there is some minimum amount of time that must be spent in this avatar to keep the others functioning, then physical well-being in the real world should be a relevant part of studying virtual world life. Even aside from debunking myths or accusations of health risks, this calls for a closer look at what the actual effects on the physical self are.